Major cerebral vessels involvement in patients with MELAS syndrome: Worth a scan? A systematic review - 25/02/21

Doi : 10.1016/j.neurad.2021.02.002

Laura Ludovica Gramegna ^a,^b,⁎ , Irene Cortesi ^b, Micaela Mitolo ^a,^b, Stefania Evangelisti ^b, Talozzi Lia ^b, Luigi Cirillo ^a,^c, Caterina Tonon ^a,^b,^{^{1
Contributed equally.}}, Raffaele Lodi ^d,^{^{1
Contributed equally.}}
^a IRCCS Istituto delle Scienze Neurologiche di Bologna, Functional and Molecular Neuroimaging Unit, Bologna, Italy
^b Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
^c Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
^d IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy

^⁎Corresponding author at: IRCCS Istituto delle Scienze Neurologiche di Bologna, Functional and Molecular Neuroimaging Unit, Via Altura 3, Bologna, 40139, Italy.IRCCS Istituto delle Scienze Neurologiche di BolognaFunctional and Molecular Neuroimaging UnitVia Altura 3Bologna40139Italy

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Thursday 25 February 2021
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Abstract

Major cerebral vessels have been proposed as a target of defective mitochondrial metabolism in patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes syndrome (MELAS). Cerebral angiographic techniques are not routinely performed in MELAS patients. A systematic literature review was performed to identify studies describing major vessel caliber alterations in MELAS. Twenty-three studies reporting on 46 MELAS patients were included. Alterations in major caliber vessels were present in 59% (27/46) of patients. Dilation occurred in 37% (17/46) of patients, and in 88% (15/17) of them during a stroke-like episode (SLE). Stenosis was reported in 24% (11/46) of patients: 36% (4/11) related to an SLE and 64% (7/11) to dissections or degenerative changes.

During an SLE, identification of intracranial vessels dilation or stenosis could be a selection tool for new treatment protocols. Outside SLE, identification of major cerebral vessels dissections and degenerative changes may help to prevent subsequent complications.

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Abbreviations : CTA, COX, DWI, DSA, ICA, MCA, MELAS, MRA, MRI, MCAD, NO, PICO, PCA, SLE, SLL, TOF